Tuberculosis: the Greatest Story Never Told: The Human Story of the Search for the Cure for Tuberculosis and the New Global Threat

by Frank Ryan

Tuberculosis is the greatest infectious killer in history. Over the last three centuries it was responsible for the deaths of a thousand million people. Feared more than cancer or even bubonic plague, it became a symbol of romantic death, robbing generations of the most celebrated artists, philosophers and writers, including Keats, Chopin, Chekhov and George Orwell, meanwhile inspiring a remarkable cultural legacy, such as the opera, La Traviata, and Thomas Mann’s Magic Mountain. The discovery of the cure for this terrible disease changed the course of human history. Half way through the twentieth century few people worldwide, whether doctors or the ordinary man or woman, believed that such a cure would ever be possible. It was left to a tiny band of unlikely heroes, scattered in different countries, to discover the impossible. Few were tuberculosis experts. Half of them were not medically qualified. This is their story.

This book tells the epic tale of the search for the cure for tuberculosis. It is an extraordinary narrative of human drama, scientific deduction, and original historical documentation. But as consultant physician, Frank Ryan, who for many years travelled worldwide gathering together the intimate details of their lives, the triumph of discovering the cure now comes with a dire warning. The greatest shock was awaiting him in New York, when he discovered that in a deadly alliance with AIDS, tuberculosis was once again threatening both the developed and developing world.

Genres: Nonfiction, Medical, Medicine, History, Science

Hardcover

First published July 16, 1992

About the author

Frank Ryan is a consultant physician in the UK as well as being an innovative evolutionary biologist, who has introduced the concepts of aggressive symbiosis to virology, and the concepts of genomic creativity and the holobiontic human genome to the story of human evolution. His major scientific interest has been the pioneering and development of the concept of viruses as symbionts, thus bringing together the disciplines of evolutionary virology and symbiology. He has a major interest in the evolution of the human genome and the implications this has for medicine.

BOOKS

Frank's books include the recently published "The Mysterious World of the Human Genome", Virolution, Metamorphosis, Darwin's Blind Spot, Virus X, and The Forgotten Plague. World in Action and Horizon based programs on Frank's books. The Forgotten Plague was a non-fiction book of the year for the New York Times. Virus X also received outstanding reviews in the New York Times and The Washington Post's Bookworld, and Darwin's Blind Spot was the book of choice for Charlie Munger in 2003.

Frank's books have also been the subject of TV and radio documentaries and have been translated into many languages. He is also an occasional reviewer of books for the New York Times.

SOCIAL LIFE

Frank is married with two children. He is an entertaining speaker, which has helped to make him popular with the live media, professional colleagues and lay audiences alike.

Reviews

[Dennis Littrell · Rating 5 out of 5]

~Ryan, Frank. Tuberculosis: The Greatest Story Never Told (1992) *****
The once and future scourge

Because I grew up during a time when tuberculosis had been (at least temporarily) conquered, I tended to think of it as a disease of the past, something that had slowly wasted away artists and languid ladies of society after many a year in a remote sanatorium, something almost romantic, more a relic of the nineteenth century than something that might threaten me.

However, one cannot read this extraordinary book without becoming fully imbued with the horror that is tuberculosis. Ryan shows in graphic language (and some photos that make one recoil), how the tuberculosis germ can eat away at human bodies, how it can poison and destroy lungs and internal organs, brain cells and bone, our skin, and indeed virtually every part of our body. One sees through Dr. Ryan's eyes a parasitic pathogen that "knows" its victims so well that one gets the sense that tuberculosis has been a cruel and grotesque tax on humankind since the first light of history, that tuberculosis is the price we've had to pay for learning animal husbandry, for agriculture, for civilization itself.

And then came the medical science of the twentieth century which developed antibiotics and chemotherapies that by the 1950s had tuberculosis so in retreat that many spoke of its eradication. Ryan brings the personalities that developed these cures and their struggles to life. We see them fight against not only the microbe but the nearly intractable belief held by most medical authorities that nothing could defeat the tuberculosis germ, that such efforts were doomed to failure, and anyone claiming otherwise was a charlatan and a fool. Ryan's book chronicles the story of the courageous, brilliant, and dogged people in the United States and in Europe--Gerhard Domagk, Rene Dubos, William Feldman, H. Corwin Hinshaw, Jorgen Lehmann, George W. Merck, Albert Schatz, Gylfe Vallentin, and Selman Waksman, to name a few of the most prominent--who actually developed a cure for this most horrible of diseases. It is a story of personal danger, intrigue, obsession, personality conflict and territorial spats, patent laws and priorities, money, jealousy and friendship--failure and eventual triumph set against the backdrop of two world wars.

How ironic the story is! How in direct contrast these two very human activities were: the heroic endeavor to cure disease, and the process of war--the latter a gross stupidity that served only to enhance the fertile ground of disease! As one reads one cannot help but exclaim, Oh, shame, shame on you humanity for your cruel and mindless stupidities! And hurrah for those who devoted their life to trying to understand the microbial world and its chemistry, to those who rose above the slaughter all around them and worked tirelessly to alleviate the pain and suffering of disease!

One wonders in reading this extraordinary story, how such grossly divergent behaviors by human beings can exist side by side: madness and the pursuit of knowledge. The nature of these schizophrenic bed fellows of humankind is what Ryan has really chronicled here.

But the story, after perhaps two decades of euphoria, takes a ominous turn sometime around 1978 with the incipient rise of "reactivation tuberculosis" and the "AIDS-tuberculosis syndrome" (pp. 395-396). Ryan shows that the struggle against TB, far from being over, is upon us once again with a new and terrible ferocity. He notes with alarm how the tubercular bacterium has continued to mutate against the drugs that once cured it while HIV-crippled immune systems allow the pathogen to once again run rampant through the bodies of the compromised. Already in our cities the tide against the "greatest killer of all time" has turned and the mortality rates are climbing. And in the developing nations, especially in sub-Saharan Africa, the disease in combination with AIDS threatens entire generations.

Ryan estimates that 1.7 billion people in the world harbor the tuberculosis germ, an astonishing number. He calls this a "global time bomb" waiting to explode. (p. 404) He quotes health officials as claiming as long ago as 1991 that Africa was "already lost."

This is a beautiful and horrifying book that chronicles one of the greatest triumphs of medical science while making all too vivid the fact that "the ageless leviathan of terror" (p. 378) is still very much with us, and is likely to continue to evade our efforts to eradicate it.

--Dennis Littrell, author of “Understanding Evolution and Ourselves”

[Kerri · Rating 5 out of 5]

Review soon!

[Ed · Rating 5 out of 5]

As much a biography of the impact onto Western culture tuberculosis as had, as a biography of the immediate cast of scientists who discovered and invented medicines that for the first time in history opened up the possibility of curing consumption. The blend of discussion of practical steps in the thinking and research of these individuals - extending into detail concerning the synthesis of the medicines involved - and the theoretical thinking and understanding these individuals exerted on the problems they were trying to solve.

TB is argued here to be one of the greatest maladies the human race has suffered throughout our history - reasonably convincingly. Without the treatments here described I am sure diseases such as malaria would be overshadowed by the variety of ills TB manifests as, and I am sure it would still carry the unique social and cultural weight it exercised in Western art, culture and life. Instead the cumulative efforts of decades of incredible research and scientific endeavour led to the creation of antibiotics as we know them, from both chemical and fungal sources - a mix of synthetic and natural cures to our ills. This process and this way of obtaining antibiotics was the absolute foundation of our approach to treating infection today and is both a blessing and a curse.

For quite a hefty book I was very surprised how quickly I flew through it. On the other hand, I was primed by Susan Sontag's essay on Illness and its Metaphors, and found the narrative very compelling. I would recommend it to most who think they would find it interesting.

[Karen · Rating 5 out of 5]

In the 1990's I worked with HIV in a pathology lab. Of course, we knew about tuberculosis being one of the big problems in patients with full blown AIDS. We also heard all of the horror stories of drug addicts who would get TB, be given medication for it, go out into the world, feel better after a couple of weeks...and then stop taking the medication. Soon, some of those patients would end up back in the hospitals with Multidrug Resistant TB. I remember in medical school reading and hearing about how TB was 'almost' conquered in the 60's and 70's, only to have HIV blow it out of control again. I had been looking for a book on what happened, and this book filled in my lack of knowledge nicely.

I loved all the information that Ryan provided. I always love history with my medicine...when I teach, I always mix interesting tidbits with my medical teaching because it helps my students to remember what I'm teaching. I particularly loved the biographies of the men and women who were involved in working towards treatments for TB. These people didn't exist in a vacuum. They had families, they experienced hardships, and jealousies of each other. It was fascinating to learn that these people were working in three or four different countries, because everyone was worried about TB.

This book really emphasized the dangers of germs like TB and their ability to develop resistance quickly to medications/antibiotics if several medications are not used to attack the bacteria at different points. And even with multiple drugs, TB was never, ever conquered, though less attention was paid to it after the 1960's which was a huge mistake. Now it's absolutely apparent from this book, that attention needs to be paid to TB again. I'm convinced we may see an increase in TB in COVID long haulers, but I also finished this book and went on Google to check about the possibility of making a new vaccine using messenger RNA such as used with COVID19, and sure enough I see evidence that this is being looked at as a tool against this historical monster.

[Darla Ebert · Rating 3 out of 5]

Wow, this book was so well-researched and informative. It does bog down in all the detail but then that is because the subject matter is so intricate and could probably only be understood by a medical person. Still anyone who reads this book will learn something of worth about the days when TB was a scary always fatal illness, though a person might hang on agonizingly for years. It was the unpredictability of the course of the disease that was maddening, well among other things. I liked the inclusion of seeming "coincidences" that played into the discovery of the medicine that would ultimately change the world and give hope.

[Frederic A Conte · Rating 5 out of 5]

Brilliant. The historical narrative was very well researched and written. I enjoyed reading the details behind the discoveries. Frank Ryan relives the struggles of diseased and the hardship and success of the numerous scientists. I have many friends who glamorise the past in the 18 and 19 hundreds, but the truth is it was a time of great suffering from infectious diseases. Frank Ryan has documented the number one killer over the history of mankind. Well done.

[Keren Lilley · Rating 5 out of 5]

Absolutely fascinating - the three different strands from different disciplines across different societies - epic true story

[Dennis Littrell · Rating 5 out of 5]

The once and future scourge

Because I grew up during a time when tuberculosis had been (at least temporarily) conquered, I tended to think of it as a disease of the past, something that had slowly wasted away artists and languid ladies of society after many a year in a remote sanatorium, something almost romantic, more a relic of the nineteenth century than something that might threaten me.

However, one cannot read this extraordinary book without becoming fully imbued with the horror that is tuberculosis. Ryan shows in graphic language (and some photos that make one recoil), how the tuberculosis germ can eat away at human bodies, how it can poison and destroy lungs and internal organs, brain cells and bone, our skin, and indeed virtually every part of our body. One sees through Dr. Ryan's eyes a parasitic pathogen that "knows" its victims so well that one gets the sense that tuberculosis has been a cruel and grotesque tax on humankind since the first light of history, that tuberculosis is the price we've had to pay for learning animal husbandry, for agriculture, for civilization itself.

And then came the medical science of the twentieth century which developed antibiotics and chemotherapies that by the 1950s had tuberculosis so in retreat that many spoke of its eradication. Ryan brings the personalities that developed these cures and their struggles to life. We see them fight against not only the microbe but the nearly intractable belief held by most medical authorities that nothing could defeat the tuberculosis germ, that such efforts were doomed to failure, and anyone claiming otherwise was a charlatan and a fool. Ryan's book chronicles the story of the courageous, brilliant, and dogged people in the United States and in Europe--Gerhard Domagk, Rene Dubos, William Feldman, H. Corwin Hinshaw, Jorgen Lehmann, George W. Merck, Albert Schatz, Gylfe Vallentin, and Selman Waksman, to name a few of the most prominent--who actually developed a cure for this most horrible of diseases. It is a story of personal danger, intrigue, obsession, personality conflict and territorial spats, patent laws and priorities, money, jealousy and friendship--failure and eventual triumph set against the backdrop of two world wars.

How ironic the story is! How in direct contrast these two very human activities were: the heroic endeavor to cure disease, and the process of war--the latter a gross stupidity that served only to enhance the fertile ground of disease! As one reads one cannot help but exclaim, Oh, shame, shame on you humanity for your cruel and mindless stupidities! And hurrah for those who devoted their life to trying to understand the microbial world and its chemistry, to those who rose above the slaughter all around them and worked tirelessly to alleviate the pain and suffering of disease!

One wonders in reading this extraordinary story, how such grossly divergent behaviors by human beings can exist side by side: madness and the pursuit of knowledge. The nature of these schizophrenic bed fellows of humankind is what Ryan has really chronicled here.

But the story, after perhaps two decades of euphoria, takes a ominous turn sometime around 1978 with the incipient rise of "reactivation tuberculosis" and the "AIDS-tuberculosis syndrome" (pp. 395-396). Ryan shows that the struggle against TB, far from being over, is upon us once again with a new and terrible ferocity. He notes with alarm how the tubercular bacterium has continued to mutate against the drugs that once cured it while HIV-crippled immune systems allow the pathogen to once again run rampant through the bodies of the compromised. Already in our cities the tide against the "greatest killer of all time" has turned and the mortality rates are climbing. And in the developing nations, especially in sub-Saharan Africa, the disease in combination with AIDS threatens entire generations.

Ryan estimates that 1.7 billion people in the world harbor the tuberculosis germ, an astonishing number. He calls this a "global time bomb" waiting to explode. (p. 404) He quotes health officials as claiming as long ago as 1991 that Africa was "already lost."

This is a beautiful and horrifying book that chronicles one of the greatest triumphs of medical science while making all too vivid the fact that "the ageless leviathan of terror" (p. 378) is still very much with us, and is likely to continue to evade our efforts to eradicate it.

--Dennis Littrell, author of the mystery novel, “Teddy and Teri”

[Greg · Rating 5 out of 5]

Really fascinating history of a disease that most people in the first world know very little about these days, but which has historically been an appallingly prevalent killer of extraordinary persistence and variation. It's not quite 'pop' history but is perfectly accessible for someone like me whose medical knowledge is basic at best, while still (as far as I can tell) being detailed enough to do justice to the subject matter. The narrative flags a little at times due more to the way events panned out historically rather than any shortcomings of the author - in the 40s and 50s there's three completely different paths of investigation going on simultaneously and the chronology can be a bit hard to keep straight, but that doesn't detract from the book at all.